What does the physiotherapeutic intervention look like?

The initial treatment of a sprained ankle is the PECH rule. Immediately after the sprain is broken, the activity is paused (P), interrupted, cooled with an ice pack (E) or cold wet cloth, compressed with a compress (C – Compression) and finally elevated against the swelling (H). This is intended to prevent excessive swelling and bleeding, so that the body can initiate wound healing.

During the inflammatory phase, which lasts the first few days, the foot is mainly relieved and cooled. The body needs some time without load to form new tissue fibers. Lymph drainage stimulates and supports the drainage of wound fluid.

In the next phase, the newly formed fibers must be aligned with their later function and direction of progression by means of adapted movement stimuli. Ultrasound applications prove to be supportive in wound healing, especially of superficial tendon tissue. Electrotherapy can also be used to support wound healing and relieve pain.

The affected and adjacent joints are gently mobilized to prevent adhesions. Without stress, stabilizing muscles around the joint can be built up early on through static exercises. If the pain is no longer the main focus, more and more active work can be done.

It is especially important to train depth sensitivity in order to prevent a renewed twisting. Balance exercises and uneven surfaces are suitable for this. In physiotherapy, there are therapy spinning tops, wobble cushions and vibration mats, among other things.

To make things more difficult, the exercises can be done on one leg, on tiptoe or combined with additional tasks such as throwing and catching a ball. Specific muscles and muscle groups can be specifically trained using Theraband. Simple exercises should be performed regularly as a home exercise program. Lack of passive stability, which consists of the capsule and ligaments, can be compensated by active stability, which is formed by strong muscles and their tendons. Even after the injury has healed, athletes in particular should continue to do balancing training to maintain a protective muscle corset and protect themselves from injury.